Is There a Precise Adjuvant Therapy for Esophagogastric Carcinoma?

Long-term survival following surgical resection of esophagogastric cancer is poor, with 5-year survival of less than 50% following surgery alone for patients with stage II or higher disease.1,2 Adjunctive therapies improve survival for these patients, although standard practice varies globally. The European Society of Medical Oncology guidelines recommend a perioperative chemotherapy approach for patients with stage IB resectable gastric cancer or higher and for patients who have not received neoadjuvant chemotherapy, postoperative chemoradiotherapy (CRT), or chemotherapy.3 For patients with locally advanced esophagogastric junction (EGJ) adenocarcinoma, either perioperative chemotherapy or neoadjuvant CRT is recommended.4 For patients with stage T1b gastric cancer, the current U.S. National Comprehensive Cancer Network guidelines recommend upfront surgery followed by surveillance or adjuvant chemotherapy or CRT, depending on pathologic stage; for patients with stage T1b or higher disease, perioperative chemotherapy or alternatively CRT is recommended.5 For patients with locally advanced EGJ adenocarcinoma, neoadjuvant CRT prior to surgery is recommended.6 In Asia, where clinical practice has been shaped by high disease incidence, national screening programs, and an early stage of diagnosis, adjuvant chemotherapy following surgery for resectable gastric cancer remains the standard of care.7 PERIOPERATIVE CHEMOTHERAPY Section: ChooseTop of pageAbstractPERIOPERATIVE CHEMOTHERAP... <